By ED PULLEN, MD
On Independence Day I thought it would be interesting to look at the causes of death of some of our famous Revolutionary era patriots. When I started researching this I anticipated early deaths from infections and untreatable chronic diseases like diabetes and hypertension. Interestingly many of the famous early Americans lived to a ripe old age, and died of causes that even today may well have been their demise.
George Washington: Washington is an exception to the comment above. Washington died at age 67, likely of a pharyngeal infection, possibly streptococcal disease. Today he would likely have received antibiotic treatment and survived this illness.
Thomas Jefferson: Jefferson really died of old age, living to age 83 and died on July 4, 1826. He survived to be the third to the last signer of the Declaration of Independence to pass. He had uremia, nephropathy, and may have died of dehydration from amoebic dysentery. The most interesting thing I found about his death was the he wrote his own epitaph, and insisted that it include “not a word more.” It did not mention his governorship of Virginia, vice-presidency or presidency:
“HERE WAS BURIED THOMAS JEFFERSON
AUTHOR OF THE DECLARATION OF AMERICAN INDEPENDENCE
OF THE STATUTE OF VIRGINIA FOR RELIGIOUS FREEDOM
AND FATHER OF THE UNIVERSITY OF VIRGINIA.”
John Adams: Like Jefferson fittingly died on July 4, 1836, just hours after Jefferson died, at age 88 making him the next to the last Declaration of Independence signer to die. He also died of old age, suffering from congestive heart failure and likely coronary disease. At age 88 he may have lived longer with the excellent heart failure treatments of today, but he certainly lived a long life. When told it was July 4th it is rumored in his last hour of life he said:
“It is a great day. It is a good day.” His last words have been reported as “Thomas Jefferson survives”. Not knowing that Jefferson had died hours earlier.
Benjamin Franklin: Although famous for having syphilis, Franklin likely died of empyema, an infection of the space between the lung and the chest wall. HE was bedridden for the last year of his life, and likely contacted pneumonia. Empyema sometimes complicates pneumonia, and though we are often able to treat pneumonia and empyema successfully today, at age 84 pneumonia is still often the “old man’s friend.”
John Hancock: Hancock died at age 56, reportedly of gout. Most likely the gout led to him being bedridden, and he died of complications of bed rest. Today we are very good at treating gout, so he would likely have lived both a better quality and longer life with modern medicine today. Of note Hancock’s funeral was the most lavish in the new America as of his death October 8, 1793.
Samuel Adams: Samuel Adams lived to age 81, dying on October 2, 1803. He suffered from what is now felt to be essential tremor, making him unable to write in his last decade. This is a condition we have pretty good success with treating today, and he would have likely had a better quality of life with modern medical help for this condition. I’m unable to find a guess as to his cause of death, but he certainly did not die prematurely.
James Madison: Madison was the last of our Founding Fathers to die on June 26, 1836 at the age of 85. As the primary author of our constitution, a major contributor to the Federalist Papers, and a key early legislator and later president, he had a brilliant mind. He seemed to struggle in his later years with anxiety, probably some dementia, and may well have benefited from an SSRI. At times his anxiety and probably depression left him essentially bedridden. He died at an old age, at the time simply called “debility.”
John Paul Jones: The naval hero of the Revolutionary war, famous for the quote, “I have not yet begun to fight,” during the engagement with the British ship Serapis in the North Sea in 1779. He died of a brain tumor at age 45. The big advantage Jones would have had today would have been a long US military career, with military health care. We still often are not terribly successful at treating brain tumors, so he may still have died at a young age.
Alexander Hamilton: Hamilton, felt by some to be our greatest Secretary of the Treasury, died after a well known duel with Aaron Burr. The bullet apparently entered in the right lower abdomen, ricocheting off the pelvis and causing liver, diaphragm, other internal organ damage and also causing spinal cord injury at about the L2 level leaving Hamilton paralyzed. He died the next day. The bullet wound may have still killed him today, although duels are thankfully a thing of the past. With modern surgery he may well have survived as a paraplegic.
To see a summary of the causes of death of each of our presidents, see How Did Each Dead President Die??
Enjoy your Independence Day weekend.
Ed Pullen, MD, is a board certified family physician practicing in Puyallup, WA. Dr. Pullen shares his viewpoints on medical news and policy from a primary care physician’s perspective at his blog, DrPullen.com.
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They spend a lot of time outdoors on their farms. Even Madison, who would otherwise suffer from episodes of depression and anxiety since childhood and was always considered fragile, they spend much time outdoors.
How do you like that? I always thought that George Washington died from Dutch Elm disease, brought on by his ill-fitted wooden dentures. 😉
I’ve been privileged to have military health care for the past twenty-eight years. I would not trade it for anything.
I’m not sure it’s their wealth that made them live longer. Their family members (children, wives) who had equal access to all wealth can provide dropped dead like flies around them, yet these men lived long productive lives.
It could be that their lifestyles were different. Jefferson for example ate very little and mostly fresh vegetables, and just like Adams and Washington, he exercised daily by taking long walks or riding horses. They spend lots of time outdoors on their farms. Even Madison, who by the way suffered bouts of depression and anxiety since childhood and was always considered “frail”, spend lots of time outdoors.
I think these guys were really made of a different “cloth” than mere mortals 🙂 It’s interesting that other great Presidents and statesmen also lived long lives and the less stellar ones did not. John Quincy lived forever and Calhoun, Clay, Webster all lived long, as did Andrew Jackson despite being ridden with old wounds, and Lincoln would have probably lived forever too if not assassinated.
Maybe there’s a longevity gene associated with the ability to navigate American politics successfully…
Wow, I actually thought about tackling this subject before settling on the physician Founding Fathers for my Fourth of July post. At any rate, I’d agree with Rick in the sense that these were all wealthy men who had many resources on which to draw from , so there longevity may not be so suprising. According to Robert Fogel (a 1993 Nobel laureate in Economics), the average life expectancy in 1800 was 56, hardly the same as 2003’s expectation of 77.5 years. There have been advances in knowledge, cleanliness, and even technology that have led to this (admitedly uneven) increase.
Technological advancement in and of itself is not a negative thing; it is the pursuit of such advancement for its own sake and not for the good it can perform that can be detrimental. Healthy skepticism and constructive criticism are vital, as is the ability to embrase the fruits that medical innovation can produce.
I find this post interesting as it documents the reverence to the founding fathers that I believe is unique to the US (compared to other western, industrialized countries).
I personally would find the question (speculation) more intriguing what works of art might have been created by artists who were creative when they expired in young or middle age: Beethoven (?), Mozart (? rheumatic fever), Schubert, Schumann (Syphilis), Chopin (TB) are the musicians coming to mind, and there are probably countless writers, directors, painters who died prematurely of treatable conditions ….
Penny, ironically those things you cite are all supposed to keep our modern healthcare system from killing people.
It’s also fair to point out that these men were all the elites of their day, had the best of everything, including healthcare, so their longevity is probably not so surprising.
“My neighbor is West Point/USMA alum, and says NEVER take him to a VA facility. I’ve never seen him go to the VA.
Sir — have you been in the U.S. military? Waited in long lines? Had uncaring treatment? Fought with bureaucrats over referrals?”
Willing and able to pay for it themselves in the private sector?
J.S.
FYI: I’ve been in the military, served as US Army physician, and military medicine is not to be confused with the VA medical care system. The military medical care system is very competent, if somewhat inconvenient. I think you are the uninformed one in this case.
The average age at death of those males you have listed is 71 years old,not far from where makes are today.
What was missing from their care were personal electronic health records with e prescribing and EMR, and when hospitalized, a CPOE.
Now how would these meaningfully expensive but useless marvels of modern medicine would have increased their life expectancy?
EXCUSE ME
” .. The big advantage Jones would have had today would have been a long US military career, with military health care ..”
My neighbor is West Point/USMA alum, and says NEVER take him to a VA facility. I’ve never seen him go to the VA.
Sir — have you been in the U.S. military? Waited in long lines? Had uncaring treatment? Fought with bureaucrats over referrals?